Significance of preoperative radiographic pancreatic density in predicting pancreatic fistula after surgery for pancreatic neuroendocrine tumors

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• 作者：Yasmine Assadipour ; M.D.^a ; Saï ; d C. Azoury ; M.D.^a ; ^b ; Nicholas N. Schaub ; M.D.^a ; Young Hong ; M.D.^a ; Robert Eil ; M.D.^a ; Suzanne M. Inchauste ; M.D.^a ; Seth M. Steinberg ; Ph.D.^c ; Aradhana M. Venkatesan ; M.D.^d ; Steven K. Libutti ; M.D. ; F.A.C.S.^e ; Marybeth S. Hughes ; M.D. ; F.A.C.S.^a ; ^b ; ^{hughesm@mail.nih.gov" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Pancreatic fistula ; Neuroendocrine tumors ; Pancreaticoduodenectomy ; Pancreatic resection ; Pancreatic enucleation
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：212
• 期：1
• 页码：40-46
• 全文大小：759 K

文摘

Postoperative pancreatic fistula remains the most severe and worrisome complication after surgery. Predictive preoperative assessment remains challenging. The authors examine the role of pancreatic computed tomography density in predicting postoperative pancreatic fistula after surgery for pancreatic neuroendocrine tumors.

Methods

A single institutional retrospective review of pancreatic surgery for neuroendocrine tumors between 1998 and 2010 was conducted. Preoperative contrast-enhanced computed tomography scans were reviewed, with mean region of interest measurements of pancreatic parenchymal density obtained from 10-mm thick axial computed tomography images.

Results

A total of 119 patients were identified: 59 with enucleations and 60 with resections. Decreased preoperative pancreatic density was significantly associated with an increased grade of postoperative pancreatic fistula (P < .01). Subgroup analyses revealed that decreased gland density was associated with increased grade of postoperative pancreatic fistula in the resection (P < .01) but not in the enucleation group (P = .34).

Conclusions

A significant association between postoperative pancreatic fistula grade and preoperative pancreatic computed tomography density is observed in patients undergoing resection for pancreatic neuroendocrine tumors.